We’ll guide you through a few simple steps, so your first visit feels focused, thoughtful, and prepared. You can keep things simple—nothing needs to be perfect.
Membership is designed for patients who want a more continuous relationship with their physician, predictable monthly care costs, and ongoing support for prevention, wellness goals, and health concerns over time.
I understand membership is not active until my enrollment information, required paperwork, and payment setup have been reviewed and accepted by the practice.*
I understand that non-member visits are billed per visit at the non-member rate and do not include ongoing membership benefits.
*Virtual visits are available for patients physically located in Missouri at the time of the visit.
It is optional to provide your medical conditions at this time.
I understand this form is a request for care, not a medical visit, and does not establish a physician–patient relationship. I agree to provide accurate information and understand my information will be handled according to the practice’s privacy policies. For emergencies, I will call 911 or go to the nearest ER.*
I agree to the Privacy Policy and understand that this form is for initial communication only.*
